Delayed resolution of jaundice in the arm of a patient with impaired lymphatic drainage: a case report.
Identifieur interne : 007303 ( Main/Exploration ); précédent : 007302; suivant : 007304Delayed resolution of jaundice in the arm of a patient with impaired lymphatic drainage: a case report.
Auteurs : Roger Y. Tsang [Canada] ; John R. MackeySource :
- Clinical breast cancer [ 1526-8209 ] ; 2007.
Descripteurs français
- KwdFr :
- MESH :
- effets indésirables : Lymphadénectomie.
- secondaire : Tumeurs du foie.
- traitement médicamenteux : Ictère, Tumeurs du foie.
- étiologie : Ictère, Prurit.
- Adulte, Bras, Femelle, Humains, Tumeurs du sein.
English descriptors
- KwdEn :
- MESH :
- adverse effects : Lymph Node Excision.
- drug therapy : Jaundice, Liver Neoplasms.
- etiology : Jaundice, Pruritus.
- secondary : Liver Neoplasms.
- therapy : Breast Neoplasms.
- Adult, Arm, Female, Humans.
Abstract
A 40-year-old woman, 6 years after mastectomy, lymph node dissection, and locoregional radiation, presented with hepatic metastases, pruritus, and jaundice. Physical examination revealed uniformly jaundiced skin and no arm lymphedema. Ultrasonography confirmed progressive hepatic metastases with no evidence of intrahepatic or extrahepatic biliary dilatation. Eight weeks after starting chemotherapy, her pruritus and jaundice were markedly improved, but the jaundice on the skin of her left arm was substantially slower to clear than the other skin areas. With further therapy, serum bilirubin normalized and her left arm jaundice completely resolved. We hypothesize that the delayed resolution of jaundice on her left arm resulted from impaired lymphatic drainage after left axillary lymph node dissection and irradiation, and conclude that lymphatic drainage might play a key role in the transport and clearance of bilirubin and related pigments from peripheral tissues.
DOI: 10.3816/CBC.2007.n.055
PubMed: 18269780
Affiliations:
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Le document en format XML
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Mackey</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2007">2007</date><idno type="RBID">pubmed:18269780</idno><idno type="pmid">18269780</idno><idno type="doi">10.3816/CBC.2007.n.055</idno><idno type="wicri:Area/PubMed/Corpus">003381</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">003381</idno><idno type="wicri:Area/PubMed/Curation">003381</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">003381</idno><idno type="wicri:Area/PubMed/Checkpoint">003381</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">003381</idno><idno type="wicri:Area/Ncbi/Merge">002B68</idno><idno type="wicri:Area/Ncbi/Curation">002B68</idno><idno type="wicri:Area/Ncbi/Checkpoint">002B68</idno><idno type="wicri:doubleKey">1526-8209:2007:Tsang R:delayed:resolution:of</idno><idno type="wicri:Area/Main/Merge">007448</idno><idno type="wicri:Area/Main/Curation">007303</idno><idno type="wicri:Area/Main/Exploration">007303</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Delayed resolution of jaundice in the arm of a patient with impaired lymphatic drainage: a case report.</title><author><name sortKey="Tsang, Roger Y" sort="Tsang, Roger Y" uniqKey="Tsang R" first="Roger Y" last="Tsang">Roger Y. Tsang</name><affiliation wicri:level="1"><nlm:affiliation>Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Medicine, University of Alberta, Edmonton, Alberta</wicri:regionArea><wicri:noRegion>Alberta</wicri:noRegion></affiliation></author><author><name sortKey="Mackey, John R" sort="Mackey, John R" uniqKey="Mackey J" first="John R" last="Mackey">John R. Mackey</name></author></analytic><series><title level="j">Clinical breast cancer</title><idno type="ISSN">1526-8209</idno><imprint><date when="2007" type="published">2007</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Arm</term><term>Breast Neoplasms (therapy)</term><term>Female</term><term>Humans</term><term>Jaundice (drug therapy)</term><term>Jaundice (etiology)</term><term>Liver Neoplasms (drug therapy)</term><term>Liver Neoplasms (secondary)</term><term>Lymph Node Excision (adverse effects)</term><term>Pruritus (etiology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Bras</term><term>Femelle</term><term>Humains</term><term>Ictère (traitement médicamenteux)</term><term>Ictère (étiologie)</term><term>Lymphadénectomie (effets indésirables)</term><term>Prurit (étiologie)</term><term>Tumeurs du foie (secondaire)</term><term>Tumeurs du foie (traitement médicamenteux)</term><term>Tumeurs du sein ()</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Lymph Node Excision</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Jaundice</term><term>Liver Neoplasms</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Lymphadénectomie</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Jaundice</term><term>Pruritus</term></keywords><keywords scheme="MESH" qualifier="secondaire" xml:lang="fr"><term>Tumeurs du foie</term></keywords><keywords scheme="MESH" qualifier="secondary" xml:lang="en"><term>Liver Neoplasms</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Ictère</term><term>Tumeurs du foie</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Ictère</term><term>Prurit</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Arm</term><term>Female</term><term>Humans</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Bras</term><term>Femelle</term><term>Humains</term><term>Tumeurs du sein</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">A 40-year-old woman, 6 years after mastectomy, lymph node dissection, and locoregional radiation, presented with hepatic metastases, pruritus, and jaundice. Physical examination revealed uniformly jaundiced skin and no arm lymphedema. Ultrasonography confirmed progressive hepatic metastases with no evidence of intrahepatic or extrahepatic biliary dilatation. Eight weeks after starting chemotherapy, her pruritus and jaundice were markedly improved, but the jaundice on the skin of her left arm was substantially slower to clear than the other skin areas. With further therapy, serum bilirubin normalized and her left arm jaundice completely resolved. We hypothesize that the delayed resolution of jaundice on her left arm resulted from impaired lymphatic drainage after left axillary lymph node dissection and irradiation, and conclude that lymphatic drainage might play a key role in the transport and clearance of bilirubin and related pigments from peripheral tissues.</div></front></TEI><affiliations><list><country><li>Canada</li></country></list><tree><noCountry><name sortKey="Mackey, John R" sort="Mackey, John R" uniqKey="Mackey J" first="John R" last="Mackey">John R. Mackey</name></noCountry><country name="Canada"><noRegion><name sortKey="Tsang, Roger Y" sort="Tsang, Roger Y" uniqKey="Tsang R" first="Roger Y" last="Tsang">Roger Y. Tsang</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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